Usefulness of vitamin C in critically ill patients: a systematic review
DOI:
https://doi.org/10.56294/sctconf2024943Keywords:
Vitamins, Ascorbic Acid, Critical Illness, Intensive Care Units, OxidativeAbstract
Introduction: Vitamin C, also known as ascorbic acid, is an essential micronutrient that plays a key role in fighting systemic inflammation in critically ill patients. Low levels of this vitamin are common in critically ill individuals due to increased oxidative stress. The objective of this study is to investigate and evaluate the use of vitamin C in critically ill patients admitted to intensive care units, with the purpose of identifying its advantages and limitations, and determining its effectiveness in reducing mortality in this group of patients.
Methods: the present study is a systematic review; previously published articles were searched in the PubMed database. The research was carried out at the university level. 14 results were obtained.
Results: results from clinical and observational studies have been controversial, but some reports suggest improvements in organ function, shorter ICU stays, and reduced mortality in certain patient groups. Other studies did not show a significant change in mortality to justify the use of vitamin C therapy.
Conclusion: controversy regarding clinical results persists; monotherapy with high doses of vitamin C presents a biologically acceptable justification. While we wait for more results, it is important to ensure that critically ill patients receive the recommended dose of vitamin C to keep their immune and metabolic function optimized and ensure daily intake for healthy people
References
1. Radke DI, Homayr AL, Stoppe C, Elke G. Vitamin C in critical illness: end of the story or still a place? Curr Opin Crit Care. 2023 Aug 1;29(4):339-345. doi: 10.1097/MCC.0000000000001054. Epub 2023 Jun 9. PMID: 37306524.
2. Oudemans-van Straaten HM, Man AMS de, De Waard MC. Vitamin C revisited. Crit Care. agosto de 2014;18(4):460.
3. Wacker DA, Burton SL, Berger JP, Hegg AJ, Heisdorffer J, Wang Q, Medcraft EJ, Reilkoff RA. Evaluating Vitamin C in Septic Shock: A Randomized Controlled Trial of Vitamin C Monotherapy. Crit Care Med. 2022 May 1;50(5):e458-e467. doi: 10.1097/CCM.0000000000005427.
4. Kressin C, Pandya K, Woodward BM, Donaldson C, Flannery AH. Ascorbic Acid in the Acute Care Setting. JPEN J Parenter Enteral Nutr. 2021 Jul;45(5):874-881. doi: 10.1002/jpen.2102. Epub 2021 Apr 26. PMID: 33675075.
5. Shrestha DB, Budhathoki P, Sedhai YR, Mandal SK, Shikhrakar S, Karki S, et al. Vitamin C in Critically Ill Patients: An Updated Systematic Review and MetaAnalysis. Nutrients. 2021;13(10):3564.
6. Padayatty S, Levine M. Vitamin C: the known and the unknown and Goldilocks. Oral Dis. septiembre de 2016;22(6):463-93. on behalf of the Canadian Critical Care Trials Group, Masse MH, Ménard J, Sprague S, Battista MC, Cook DJ, et al. Lessening Organ dysfunction with VITamin C (LOVIT): protocol for a randomized controlled trial. Trials. 2020;21(1):42
7. Rosengrave, P., Spencer, E., Williman, J. et al. Intravenous vitamin C administration to patients with septic shock: a pilot randomised controlled trial. Crit Care 26, 26 (2022). https://doi.org/10.1186/s13054-022-03900-w
8. Xu C, Yi T, Tan S, Xu H, Hu Y, Ma J, et al. Association of Oral or Intravenous Vitamin C Supplementation with Mortality: A Systematic Review and MetaAnalysis. Nutrients. 12 de abril de 2023;15(8):1848.
9. Lamontagne F, Masse MH, Menard J, Sprague S, Pinto R, Heyland DK, et al. Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. N Engl J Med. 23 de junio de 2022;386(25):2387-98.
10. Lv SJ, Zhang GH, Xia JM, Yu H, Zhao F. RETRACTED ARTICLE: Early use of high-dose vitamin C is beneficial in treatment of sepsis. Ir J Med Sci 1971 -. agosto de 2021;190(3):1183-8.
11. Spoelstra-de Man, A.M.E., Elbers, P.W.G. & Oudemans-van Straaten, H.M. Making sense of early high-dose intravenous vitamin C in ischemia/reperfusion injury. Crit Care 22, 70 (2018). https://doi.org/10.1186/s13054-018-1996-y
12. Sevransky JE, Rothman RE, Hager DN, et al. Effect of Vitamin C, Thiamine, and Hydrocortisone on Ventilator- and Vasopressor-Free Days in Patients With Sepsis: The VICTAS Randomized Clinical Trial. JAMA. 2021;325(8):742–750. doi:10.1001/jama.2020.24505
13. Liang H, Mu Q, Sun W, Liu L, Qiu S, Xu Z, Cui Y, Yan Y and Sun T (2023) E????ect of intravenous vitamin C on adult septic patients: a systematic review and meta-analysis. Front. Nutr. 10:1211194. doi: 10.3389/fnut.2023.1211194
14. McGregor GP, Biesalski HK. Rationale and impact of vitamin C in clinical nutrition. Curr Opin Clin Nutr Metab Care. 2006 Nov;9(6):697-703. doi: 10.1097/01.mco.0000247478.79779.8f.
15. Zhang M, Jativa DF. Vitamin C supplementation in the critically ill: A systematic review and meta- analysis. SAGE Open Med. 2018;6:205031211880761.
16. Cai B, Lv X, Lin M, Feng C, Chen C. Clinical efficacy and safety of vitamin C in the treatment of septic shock patients: systematic review and meta-analysis. Ann Palliat Med. abril de 2022;11(4):1369-80.
17. Kashiouris MG, L’Heureux M, Cable CA, Fisher BJ, Leichtle SW, Fowler AA. The Emerging Role of Vitamin C as a Treatment for Sepsis. Nutrients. 22 de enero de 2020;12(2):292.
Published
Issue
Section
License
Copyright (c) 2024 Karoline Sousa do Nascimento, Fernando Lipoyestky (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.
